Individual
GENEI S BOUGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
400 GULF BREEZE PKWY, SUITE 300, GULF BREEZE, FL 32561-4495
(850) 932-5055
(850) 932-1404
Mailing address
400 GULF BREEZE PKWY, SUITE 300, GULF BREEZE, FL 32561-4495
(850) 932-5055
(850) 932-1404
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN 2565762
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302858500
—
FL
Enumeration date
08/10/2005
Last updated
12/29/2011
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